摘要
目的 比较肝细胞癌合并门静脉癌栓 (tumorthrombiinportalvein ,PVTT)不同治疗方法的疗效及其意义。方法 147例肝细胞癌伴门静脉主干或第 1分支癌栓的住院患者 ,按不同治疗方法分成 4组 :保守治疗组 (A组 ,18例 ) ;肝动脉结扎和 (或 )肝动脉插管化疗组 (B组 ,18例 ) ,术后定期栓塞化疗 ;肝癌联同PVTT切除组 (C组 ,79例 ) ;手术切除 +肝动脉化疗栓塞和 (或 )肝动脉置管或门静脉置管组 (D组 ,32例 )。结果 A组中位生存期 2个月 ,1,3,5年生存率分别为 5 .6 % ,0 ,0。B组中位生存期 5个月 ,术后 1,3,5年生存率分别为 2 2 .2 %、5 .6 %和 0。C组中位生存期 12个月 ,术后 1,3,5年生存率分别为 5 3.9%、2 6 .9%和 16 .6 %。D组中位生存期 16个月 ,术后 1,3,5年生存率分别为 82 .8%、48.8%和 41.3%。各组生存率比较 ,差异均有显著性 (P <0 .0 5 )。结论 肝细胞癌伴PVTT行手术切除可明显提高疗效 ,改善患者生活质量 ,延长生存期 。
Objective To compare the therapeutic effect and significance of different treatment methods for hepatocellular carcinoma (HCC) with portal vein tumor thrombi (PVTT).Methods One hundred and forty seven HCC patients with tumor thrombi in the main portal vein or the first branch of portal vein were divided into four groups. A,conservative treatment group ( n =18); B, hepatic artery ligation (HAL) and/or hepatic artery infusion (HAI) group ( n =18), periodically received postoperative chemoembolizations; C, excision of HCC with removal of PVTT group ( n =79); D, transcatheter hepatic arterial chemoembolization or portal vein infusion (PVI) or HAI after operation group ( n =32). Results The median survival period was 2, 5, 12, and 16 months in group A, B, C, D, respectively. Their 1 , 3 and 5 year survival rates was 5.6%, 0 and 0 in group A; 22.2%, 5.6% and 0 in group B; 53.9%, 26.9% and 16.6% in group C; 82.8%, 48.8% and 41.3% in group D, respectively. The survival rates differed significantly between the 4 groups ( P <0.05).Conclusion Resection of cancer with removal of tumor thrombi for HCC with PVTT significantly improves the curative effect and quality of life. Local hepatic chemotherapy or chemoembolization after tumor resection with removal of tumor thrombi may further prolong survival period.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2000年第3期247-249,共3页
Chinese Journal of Oncology
基金
上海市百人计划资助项目 !( 97BR0 2 9)
上海市科技发展基金!( 9844190 67)
关键词
肝肿瘤
肝细胞癌
门静脉癌栓
治疗方法
比较
Liver neoplasm/therapy
Carcinoma, hepatocellular/therapy
Chemoembolization, therapeutic
